Recruitment order of motor neurons promoted by epidural stimulation in individuals with spinal cord injury.
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Published version
Author(s)
Ibáñez, Jaime
Angeli, Claudia A
Harkema, Susan J
Farina, Dario
Rejc, Enrico
Type
Journal Article
Abstract
Spinal cord epidural stimulation (scES) combined with activity-based training can promote motor function recovery in individuals with motor complete spinal cord injury (SCI). The characteristics of motor neuron recruitment, which influence different aspects of motor control, are still unknown when motor function is promoted by scES. Here, we enrolled five individuals with chronic motor complete SCI implanted with an scES unit to study the recruitment order of motor neurons during standing enabled by scES. We recorded high-density electromyography (HD-EMG) signals on the vastus lateralis muscle and inferred the order of recruitment of motor neurons from the relation between amplitude and conduction velocity of the scES-evoked EMG responses along the muscle fibers. Conduction velocity of scES-evoked responses was modulated over time, whereas stimulation parameters and standing condition remained constant, with average values ranging between 3.0 ± 0.1 and 4.4 ± 0.3 m/s. We found that the human spinal circuitry receiving epidural stimulation can promote both orderly (according to motor neuron size) and inverse trends of motor neuron recruitment, and that the engagement of spinal networks promoting rhythmic activity may favor orderly recruitment trends. Conversely, the different recruitment trends did not appear to be related with time since injury or scES implant, nor to the ability to achieve independent knees extension, nor to the conduction velocity values. The proposed approach can be implemented to investigate the effects of stimulation parameters and training-induced neural plasticity on the characteristics of motor neuron recruitment order, contributing to improve mechanistic understanding and effectiveness of epidural stimulation-promoted motor recovery after SCI.NEW & NOTEWORTHY After motor complete spinal cord injury, the human spinal cord receiving epidural stimulation can promote both orderly and inverse trends of motor neuron recruitment. The engagement of spinal networks involved in the generation of rhythmic activity seems to favor orderly recruitment trends.
Date Issued
2021-09-01
Date Acceptance
2021-08-05
Citation
Journal of Applied Physiology, 2021, 131 (3), pp.1100-1110
ISSN
1522-1601
Publisher
American Physiological Society
Start Page
1100
End Page
1110
Journal / Book Title
Journal of Applied Physiology
Volume
131
Issue
3
Copyright Statement
Copyright © 2021 The Authors
Licensed under Creative Commons Attribution CC-BY 4.0. Published by the American Physiological Society.
Licensed under Creative Commons Attribution CC-BY 4.0. Published by the American Physiological Society.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34382840
Subjects
epidural stimulation
motor neuron
recruitment order
spinal cord injury
standing
Electromyography
Epidural Space
Humans
Motor Neurons
Spinal Cord
Spinal Cord Injuries
Spinal Cord Stimulation
Publication Status
Published
Coverage Spatial
United States